Maternity for Engineers: Pregnancy

Last year I was pregnant and had a baby for the first time! I thought a lot of the resources on pregnancy, giving birth, and parenting could have been better organized, more logical and concise. My husband and I kept semi-joking that what I really wanted was a "Maternity for Engineers" guide. It's less about parenthood specific to someone who works in tech and more just like, "let's drill down into what the core principles to keep in mind are, and be logical."

As far as I know, this doesn't exist yet, and now that some of my close friends are also getting pregnant, I thought I'd start writing out some of it before I forget. This post is what I'll send to my friends if they ask for advice on the pregnancy. If you are interested in "Paternity for Engineers: Pregnancy", I'll refer you to this post The Programmer's Guide to Pairing on Pregnancy.

GETTING PREGNANT

This obviously can be a pretty big topic. To get started, the book Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health is surprisingly accessible and interesting on how female fertility works. There's so much that isn't taught to you at all!

If you decide to start tracking your basal body temperature, the Kindara Wink is a pretty handy device to do so since it syncs to a phone app and does the charting for you.

Finally, lubricant that's formulated to be more sperm-friendly is a thing.


BEING PREGNANT

Congratulations!! Especially in the early weeks, if you're not feeling well, I recommend packing yourself a small kit to bring when you're out and about. Mine included:

• an air sickness bag that I grabbed from the last flight I was on (just having one on me made me feel more relaxed and less likely to puke in public, I found)
• saltine crackers and nut butter packets (I found that not getting too hungry was helpful for reducing general nausea)
• solid perfume in a tolerable scent (my sense of smell got SO strong, I put a little of this right under my nose when I was on public transit as needed)

For the rest...

The number one thing I would recommend to everyone that's going to give birth is to hire a doula. A doula's job is to support you throughout your pregnancy and labor. I was pretty skeptical about doulas at first--even the word sounds pretty hippie to me--but apparently even just having someone (not family) be present in the room during a birth is correlated with fewer medical interventions.

Also, at least some incidences of postpartum depression are due to needing to come to terms with a birth not happening how it had been envisioned. This isn't necessarily from unavoidable medical complications that come up, but rather, feeling like you got pushed around by others when you were in such a vulnerable state. A doula is someone who is on your side and has experience with what's normal to expect or not, who cares about you, but isn't emotionally caught up in everything the way your family and friends would be. You can look for a doula that's a good fit for you in their communication style, presence, and background. I asked for doulas that were well-versed on the science side, and then between the two we were matched up with, I chose the one I just felt really comfortable with in person.

We met ours through a local doula agency and she was so amazing that I hope we'll be able to keep in touch for years to come. She met with us a couple times beforehand and taught us how labor works and what to expect, such that we probably could've skipped some of the birth prep classes. We texted and emailed often when I had questions that weren't quite medical enough in nature to bring to my OB. She helped us figure out the kinds of procedures we might want or not want (the so-called "birth plan", which doesn't have to be a fancy thing and can be just about establishing your preferences ahead of time so that you don't have to make a bunch of decisions during the hecticness of the actual labor). When I went into labor, she came over to our house and coached me through how to cope with the contractions as they got stronger, reminding me of different positions to try. We'd learned and practiced those in one of the classes, but it was really, really helpful to be able to just turn things over to this other person who I felt safe with and trusted their knowledge on labor. She also made sure that neither I nor my husband would tire ourselves out too early from being excited that things were happening.


tl;dr on food & exercise during pregnancy: be healthy, don't fall, and don't get food poisoning.

When I got pregnant, I had the vague sense that you were supposed to read a bunch of books and take some classes for the pregnancy and giving birth. I also had the sense that you have to memorize these long lists of what you're not supposed to eat or drink. The "how are you supposed to do pregnancy well" part was actually simpler than I had expected.

It turns out that healthy habits for a pregnant person are not actually all that different than healthy habits for a non-pregnant person. Doctors won't necessarily make this distinction between what you might have to pay extra attention to specifically because of being pregnant. I think this is because they get used to advising everyone on how to be healthier and some folks might be more motivated during a life change like being pregnant. But if you were already knowledgeable on how to eat well and exercised regularly, there isn't actually that much to change.


FOOD

I was surprised to learn that "eating for two" isn't really a thing. You need more additional calories each day to breastfeed (~500) than you do while pregnant (~300). Listen to your body for when you're hungry and eat to satiation. For the first few months, if you don't have much of an appetite, anything goes. Once your nausea hopefully settles, it's the usual eat vegetables and get enough protein in. You can take supplements like prenatal vitamins and folic acid if you want, but a nutritious diet overall is probably more effective. The benefits to be gained from folic acid are from pretty early on too, like the first 7 weeks, so you might to start this even before you know that you're pregnant.

It's probably a good idea to at least reduce your alcohol and caffeine intake as no one really knows the exact effects of those substances for your particular pregnancy, negative (fetus processing the substances), neutral, or positive (the mother feeling taken care of is good for the fetus). Unpasteurized milk products and soft cheeses, runny eggs, deli meats, sushi--these are things you're told to avoid because in some cases, pregnancy does elevate your risk of getting sick, and when you do get sick, you may not be able to receive the typical treatment. So you can make tradeoffs for yourself based on what you know about the sources of your food.

Added 2023: for my third pregnancy, I discovered the work of nutritionist Lily Nichols and would highly recommend her books, especially if you are at risk for or diagnosed with gestational diabetes. She reviews published research and has a lot of clinical experience for evidence-based recommendations. One caveat though is that it may be harder to get through her book if you are vegetarian or vegan. Here is an Evidenced Based Birth podcast episode interviewing her.


EXERCISE

For exercise, if you were doing something regularly before you got pregnant, doctors feel more reassured that you know what you're doing there. I kept doing weightlifting throughout most of my first trimester but because your body's changing all the time and you don't know what its new limits might be, I was advised not to push with going heavier and therefore switched to other activities because I got bored. Keep moving and don't fall. Doing more sitting on a yoga ball and avoiding driving or reclining back too much during your last trimester is helpful for getting your baby into a better position for an easier labor.

Everyone will recommend swimming and/or prenatal yoga. I have suspicions that some of this is from those sports having a reputation as being much gentler than others and having a cultural practice of treating pregnant women very delicately. Swimming is nice when you're pregnant in the summer and feeling really hot and swollen. Prenatal yoga ended up being more useful than I thought with loosening your hips and getting advice on stretches to soothe the particular aches you might be feeling, especially in the third trimester. Also it was kind of nice to see so many other pregnant women all together.

A less common yet useful recommendation is to consider going to see a pelvic floor physical therapist, even before you give birth. I ended up with a third degree tear, which has healed now, but I might've been able to learn some techniques from a physical therapist beforehand that would reduce the likelihood of having a tear. People often recommend doing Kegels but it turns out that I never really understood what that meant, and a physical therapist could have taught me (plus in my case, it's probably more that I needed to learn how to relax my pelvic floor muscles, not tighten them further).

Finally, when you are tired, take naps if you can. Your body is wisely trying to get you to rest up as much as possible.


BOOKS

Here are the books on pregnancy, giving birth, and the early days with a baby that I would recommend (Amazon affiliate links below):

• Mayo Clinic Guide to a Healthy Pregnancy: this was recommended to me over the "What to Expect When You're Expecting" series which apparently is a lot more fear-mongering. I liked it, it was nice to have a reference guide on hand for reading about what's happening during different months of the pregnancy.
• Real Food For Pregnancy, and Real Food For Gestational Diabetes: these are a firehose of information, which I love. Note that they may be frustrating for vegetarians and vegans though.
• The Birth Partner: this reinforced a lot of the stuff that was in our birth prep class. It's nice to have something for any partners of the pregnant person to read but I took a look at it too. It's well-written and straightforward. Talks about more "natural" birth options without judging for or against them too much.
• The Nursing Mother's Companion: if you want to breastfeed, this is a good go-to reference to have on hand. I would recommend going to a class first (see below section on classes).
• If you're at all curious about having a "natural" or unmedicated birth, the person you'll hear a lot about is Ina May Gaskin. She's basically the founder of the midwife revival in the U.S. so her stuff is pretty on the hippie side, but she's got so much experience that it's more trustworthy than I would have initially judged. Her breastfeeding book is good, as is her guide to childbirth, as long as you carry the grain of salt that she's writing about medical practices that are a bit older. At least in the Portland area, even hospital practices are pretty progressive. I enjoyed reading the different birth stories in the childbirth book because they do cover a range of experiences (except scheduled C-sections, I think) but aren't as lengthy as some of the birth stories written up by bloggers. This book also helped me learn why you might want a midwife and/or a home birth, to the point that I would seriously consider those options for the next time around. The best part is taking in the attitude that women's bodies are designed to make giving birth possible and that you don't have to look at giving birth as just a dangerous activity where you do all this extra stuff "just in case" (the common medical attitude).
• The Science of Mom: A Research-Based Guide to Your Baby's First Year: I loved this book! It was the most actually scientifically rigorous book that I read, because other books purported to be science-based but weren't very good at presenting the research neutrally. This mostly covers decisions to be made post-delivery.
• The Happiest Baby on the Block: the 1 hour video, not the book. This introduces the concept of "the fourth trimester" and teaches you how to soothe babies in their first few months. Extremely useful.
• Heading Home With Your Newborn: From Birth to Reality: if you are a first-time parent and don't have much experience caring for babies, this book is a great guide for the actual logistics of caretaking.
• Birth Day: A Pediatrician Explores the Science, the History, and the Wonder of Childbirth: just an enjoyable memoir by a pediatrician about births. I learned interesting stuff about the history of medicine around childbirth.
• Great with Child: Letters to a Young Mother: a collection of letters from a mother to a friend of hers that has beautiful reflections on what it feels like to become and be a mom.

I think I'll do a separate post on parenting books at a later point, since I'm working on a couple of ones about Montessori but haven't finished them yet.

CLASSES

We got discounts on a bunch of classes through our doula. The most useful ones were the express birth prep (one 8-hour class rather than several hours one evening for several weeks in a row) and the breastfeeding classes. You might think, breastfeeding is natural, why do you need a class about it? I  have learned a lot about breastfeeding in the last few months but to summarize, I like the phrase "breastfeeding is natural but that doesn't mean easy." If breastfeeding is something that's important to you, it's good to learn about what to do in the early days and how to know if things are going well. Getting support early, preferably from lactation consultants who are IBCLCs and work outside of the hospital, will make a big difference in setting you up for success. I might write a separate blog post about breastfeeding in particular at some point.

It's also a good idea to take an infant CPR class at some point. We took it after the baby had been born because we could bring the baby with us to class. You don't actually practice on your baby that's breathing just fine, but it's kind of nice to have gotten familiar with what holding a real baby is like. On the other hand, having the baby with us also meant that the person who was in charge of the baby at the time missed whatever was being said.


OTHER TIPS

After having your baby, know that the second night is very hard and that's totally normal. Our hospital gave us a packet of informational handouts and it included one about the second night in particular, which we read on...day 3.


You can grab all the supplies in the room, housekeeping will just restock anyway and it's great to have lots of extra, especially all the postpartum items and wipes etc.


Reference guides I made for myself that I should clean up and share: proposed schedule of tasks during pregnancy, reference guide for breastfeeding in the early days and weeks. I'll clean up and share them if anyone asks for them, I suppose.